July 8, 2010
A routine HIV screening program in Rhode Island jails detected a significant portion of the state's new infections, according to a study in CDC's Morbidity and Mortality Weekly Report. Nonetheless, the effort continues to struggle for the funding it receives from the state's Adult Correctional Institutions (ACI).
During 2000-2007, the Rhode Island Department of Corrections program administered 102,229 HIV tests within 24 hours of jail admission, representing an estimated 40,000-60,000 unique detainees and 73 percent of admissions. The program resulted in 169 new HIV diagnoses, representing 15 percent of all HIV cases previously unreported to the state Department of Health over the period. Of the 169 new cases, administrative records for 80 (48 percent) did not indicate HIV risk factors, possibly because the inmates were reluctant to disclose such information.
The retrospective study shows both the feasibility of jail-based HIV testing and its importance for the state, said lead study author Curt Beckwith, an infectious-disease specialist at Miriam Hospital in Providence.
Because of staffing constraints, the screening program lapsed last October and did not resume until April, said Michael Fine, who became director of ACI's medical department in February. Consultants with Miriam Hospital talked with Fine about the program's importance, helping to spur Fine and staff to work to revive it, he said.
If HIV testing had been delayed for seven days after intake, 72 of the prisoners diagnosed HIV-positive (43 percent) would have already been discharged. The blood tests used typically return results in about one to two weeks. The state corrections and health departments work collaboratively to deliver confirmed HIV-positive results and refer individuals to treatment in prison or in the community post-release.
The full report, "Routine Jail-Based HIV Testing -- Rhode Island, 2000-2007," was published in Morbidity and Mortality Weekly Report (2010;59(24):742-745).